Individual provider Active NPI

Lillian Elisa Santana-Resto, OD

  • Optometrist
  • New York, NY
National Provider Identifier
1477651529
Registry record updated Apr 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUVOO4957 Issued in NY
Practice address
274 W 125TH St
All Eyes on US, Inc.
New York, NY 10027-4410
Phone
(212) 663-1511
Fax
(212) 663-1510
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUVOO4957 NY Primary

Addresses

Primary practice location

274 W 125TH St
All Eyes on US, Inc.
New York, NY 10027-4410

Mailing address

1065 Southern Blvd
Bronx, NY 10459-2417
Phone (718) 589-2440

Other identifiers 2

IdentifierTypeStateIssuer
11510086OtherNYCAQH PROVIDER ID
02666535MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051203000021 NY Practitioner - Optometry 8921028069 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUVOO4957NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Urban Health Plan, Inc. CurrentSince Mar 10, 2019 Accepting new patients
Urban Health Plan, Inc. CurrentSince Mar 10, 2019 Accepting new patients
Urban Health Plan, Inc. Current Accepting new patients
All Eyes on US Inc Past Accepting new patients

Locations

3209 3rd Ave
Bronx, NY 10451
Phone (347) 284-0203

1065 Southern Blvd
Bronx, NY 10459
Phone 71858924404222

1515 Southern Blvd
#H
Bronx, NY 10460
Phone (718) 589-1600

3712 108th St
Corona, NY 11368
Phone (718) 639-4107

4510 94th St
Elmhurst, NY 11373
Phone (347) 748-6115

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1477651529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104592417",
            "telephone_number": "718-589-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 W 125TH ST",
            "address_2": "ALL EYES ON US, INC.",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274410",
            "telephone_number": "212-663-1511",
            "fax_number": "212-663-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTANA-RESTO",
        "first_name": "LILLIAN",
        "middle_name": "ELISA",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUVOO4957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "11510086",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02666535",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.